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History Marasmus well known for centuries Kwashiorkor: Cicely Williams – Ga tribe in Ghana “the sickness the older child gets when the next baby is born” – Starch edema, sugar babies Similar but different diseases

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How many? 36% of children in the world are underweight 43% stunted 9% wasted Better nutrition, but more children in high risk areas, yields more children affected.

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Recovery? At home Reach weight for height and replete muscle mass – Normal is 25-75% weight for height and continue for one months after Treat other deficiencies Family problems Who does this include here? – Tube feeding. – Disabilities – FTT

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What does it mean? Poverty – Correlation of income, wt, ht and hgb in US – What is wealth? – Importance of food choice Brain development – Iron deficiency: neuro transmitters – Brain waves:

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What does it mean? Learning: – Difference in treatment by parents Duration of breastfeeding Expectations – Long term effects INCAP two villages, one protein and one calorie At 18 protein supplemented group had higher performance scores irrespective of educational exposure. They had taught themselves.

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What does it mean? Learning: – Difference in treatment by parents Duration of breastfeeding Expectations – Slums of Kingston, Jamaica Educational intervention, early rise plateau Nutritional intervention, late rise Additive effect Education lasts, not nutrition, but high IQ mom’s and nutrition group did as well as education.